Paranoid Psychosis: Prevalence And Features
Paranoia is a standalone symptom that may sometimes be associated with certain mental illnesses or mental states. Psychosis is a mental state that frequently causes paranoia, depending on its cause. Exploring paranoia and psychosis in depth may help individuals learn more about how paranoia can be managed and how to find mental health support.
What is paranoid psychosis?
Paranoid psychosis is a mental state and cluster of symptoms that can cause anxious thoughts and feelings involving themes of persecution, perceived threats, conspiracy, or imminent threat. While symptoms of paranoia may present in many mental health conditions, they often accompany delusional disorder and other psychotic disorders.
Anyone can become suspicious of others in certain situations, and in some cases, mistrust may be warranted by an individual's circumstances. However, believing that others intend to harm or interfere with you despite evidence to the contrary can be isolating and detrimental to mental health. A person with paranoid delusions, for example, may hold false beliefs that are difficult to disprove given evidence to the contrary. While some delusions involve paranoia, others do not. In addition, for psychosis to be labeled “paranoia psychosis” other psychotic symptoms must also be present, such as hallucinations and severe delusions.
Common delusions
A person with paranoid delusions may hold false beliefs that one refuses to dispute despite evidence to the contrary. According to the National Institutes of Health (NIH), the most common delusions involve:
- Delusional jealousy, involving a strong belief that one's partner is unfaithful
- Persecutory delusions relating to themes of being attacked, harassed, impeded from achieving goals, harmed, conspired against, or ridiculed and dismissed
- Grandiosity delusions, involving a sense of being especially important or superior to others, possessing immense and unusual talent, power, knowledge, or skills
- Thought broadcasting delusions related to believing that others can perceive one's thoughts
- Thought insertion delusions, referring to a belief that an exterior source has infiltrated one's mind
- Somatic delusions related to physical sensations and functions, such as believing one has lost control of one's limbs
A belief must fall outside one's cultural context to be considered a delusion. For example, what may be regarded as an unusual belief in one culture may be widely accepted in another culture or social context. Mental Health America (MHA) lists persecutory delusions and delusions of grandeur as two of the more prevalent delusions.
Psychotic symptoms
Psychosis is a group of symptoms that affect or distort one's perception of reality. During a psychotic episode, a person may have difficulty perceiving reality as others typically view it. Symptoms may include:
- Delusions: Delusions are firm and false beliefs that are not easily swayed.
- Hallucinations: Hallucinations are sensory perceptions that are not truly occurring, such as seeing, hearing, or perceiving stimuli others can’t.
- Disorganized behavior: Other symptoms, such as incoherent or nonsensical speech and behavior, may be considered inappropriate by others.
Someone with psychosis might also experience a loss of motivation, confusion, anxiety, and difficulty with daily functioning.
While psychosis may be experienced by anyone under certain circumstances—often concerning high stress—it often accompanies a mental health condition. Some figures state that psychosis may affect 3.5% of the population, a figure more than three times higher than the diagnosis of schizophrenia.
Symptoms prior to the onset of psychosis
Before a person develops psychosis, they may experience gradual changes involving:
- Paranoia or suspiciousness
- Challenges with logical thinking
- Social withdrawal or a desire to spend more time alone
- Unusual feelings, sensations, or ideas
- The absence of emotions
- Less interest or attention to self-care and hygiene
- Sleep disturbances
- Difficulty with communication
- Reduced performance at school or work
- Challenges differentiating what is real from what is not
Paranoia and psychosis
Paranoia can be considered a feature in some mental health conditions—from schizophrenia spectrum disorders to bipolar disorder and delusional disorder. Characterized as a "key symptom" in psychosis, it may be partially linked to adverse early life experiences and an insecure attachment style.
Psychosis is not considered a mental health condition in and of itself; instead, it relates to a group of symptoms that may accompany some mental disorders. According to recent findings, borderline personality disorder (BPD) is associated with the highest score on the Brief Symptom Inventory (BSI) in paranoid ideation. Some people with BPD may experience psychosis. However, psychosis is not a criterion for this condition.
Postnatal psychosis
Postnatal psychosis, also known as puerperal psychosis, can be considered a severe form of postpartum depression or a subtype of brief psychotic disorder that may cause paranoia. According to some figures, it's estimated postnatal psychosis affects one in every 1000 gestational parents. Often, symptoms manifest within the first few days to six weeks following childbirth.
Symptoms of postnatal psychosis may include:
- Delusions, which may involve paranoia about a partner or other caregivers
- Disorientation and confusion
- Difficulty concentrating
- Agitation and difficulty sitting still
- Insomnia
- Hallucinations
- Mania or an extremely elevated mood
- Severe mood swings
Factors related to postnatal psychosis
Factors that may contribute to the development of postpartum psychosis include genetic predisposition and previous experience of postpartum psychosis. Sleep disturbances, hormonal changes, and bipolar disorder may also play a significant role. However, psychosis can affect gestational parents without any history of mental illness.
Seek support from your general practitioner, medical nurse, and those involved in your care if you believe you or someone you know has developed postnatal psychosis. If you’re experiencing postpartum depression and have the urge to harm yourself or your child, please call 988 for immediate support. If you’re looking for peer support, you can contact the Postpartum Support International HelpLine at 1-800-4773 for resources and guidance.
Psychosis and bipolar disorder
The American Psychological Association (APA) characterizes bipolar disorder as "a serious mental illness in which common emotions become intensely and often unpredictably magnified." Bipolar disorder is linked with manic or hypomanic episodes of unusually elevated or irritable moods that interfere with functioning. There are three main types of bipolar disorder: bipolar I disorder, bipolar II disorder, and cyclothymic disorder.
According to some findings, psychotic symptoms may be considered common in "manic, depressive, and mixed episodes of bipolar disorder." Delusions are associated with bipolar I disorder in connection with mania, where paranoid delusions may be present.
Paranoid psychosis treatment
Often, the treatment of psychosis involves the use of antipsychotic medication and therapy. One evidence-based approach to treatment that may be recommended is cognitive-behavioral therapy (CBT) to address unhelpful ways of thinking and behaving.
If you or someone you know are experiencing distressing symptoms, seek a mental health specialist for an evaluation. While there is no definitive diagnosis for psychosis itself, a specialist can discuss your symptoms with you and determine if there's an underlying mental health condition or other causes linked to your experiences.
Considering therapy
If you or someone you know are at risk for developing psychosis or are experiencing symptoms, seek out a psychiatric evaluation. Seeing a therapist can also be invaluable for finding ways to manage stress and reexamine how situations may be perceived and addressed.
Online therapy through platforms like BetterHelp can be convenient for those who struggle to access in-person support. On an online platform, you can have sessions with a licensed therapist from your home. You can speak to a therapist via phone, video, or in-app. These options may be helpful when you want a provider to be responsive and convenient to access. Online platforms offer similar modalities to in-person therapy, including CBT.
One study suggests that "online interventions are both feasible and acceptable for individuals with psychotic disorders and may be effective in assisting with clinical and social outcomes." The same study noted that online therapy is associated with alleviated psychotic symptoms.
Takeaway
Anyone can become mistrustful of others in certain situations, and distrust may be warranted in certain cases. However, believing that others intend to harm you despite evidence to the contrary can be detrimental to mental health. A person with paranoid delusions, for instance, may hold false beliefs that cannot be disproven by evidence to the contrary, causing considerable distress.
Psychosis is a set of symptoms involving hallucinations, delusions, confused thinking patterns, and other experiences. Paranoid psychosis can be described as intense, anxious feelings and thoughts that may include themes of persecution, perceived threats, or conspiracy. While symptoms of paranoia may present in many mental health conditions, they often accompany psychotic disorders.
If you or someone you know are experiencing distressing symptoms of psychosis, seek out a psychiatric evaluation. Seeing a therapist can also be invaluable for finding ways to manage stress and reexamine how situations may be addressed. Consider reaching out to a provider online or in your area for personalized guidance.
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